TY - JOUR
KW - Adult
KW - African Americans
KW - Counseling/methods/statistics & numerical data
KW - Delivery of Health Care, Integrated/methods/organization & administration
KW - Depression/prevention & control
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Intervention Studies
KW - Mass Screening/methods
KW - Patient Satisfaction
KW - Pregnancy
KW - Pregnancy Complications/epidemiology/prevention & control/psychology
KW - Prenatal Care/methods/statistics & numerical data
KW - Preventive Health Services/methods/organization & administration
KW - Risk Factors
KW - Risk Reduction Behavior
KW - Sexually Transmitted Diseases/prevention & control
KW - Smoking Cessation/methods
KW - Socioeconomic Factors
KW - Spouse Abuse/prevention & control
KW - Stress, Psychological/epidemiology/prevention & control
KW - Tobacco Smoke Pollution/prevention & control/statistics & numerical data
KW - United States
KW - Urban Health
AU - K. S. Katz
AU - S. M. Blake
AU - R. A. Milligan
AU - P. W. Sharps
AU - D. B. White
AU - M. F. Rodan
AU - M. Rossi
AU - K. B. Murray
A1 - 
AB - BACKGROUND: African American women are at increased risk for poor pregnancy outcomes compared to other racial-ethnic groups. Single or multiple psychosocial and behavioral factors may contribute to this risk. Most interventions focus on singular risks. This paper describes the design, implementation, challenges faced, and acceptability of a behavioral counseling intervention for low income, pregnant African American women which integrated multiple targeted risks into a multi-component format. METHODS: Six academic institutions in Washington, DC collaborated in the development of a community-wide, primary care research study, DC-HOPE, to improve pregnancy outcomes. Cigarette smoking, environmental tobacco smoke exposure, depression and intimate partner violence were the four risks targeted because of their adverse impact on pregnancy. Evidence-based models for addressing each risk were adapted and integrated into a multiple risk behavior intervention format. Pregnant women attending six urban prenatal clinics were screened for eligibility and risks and randomized to intervention or usual care. The 10-session intervention was delivered in conjunction with prenatal and postpartum care visits. Descriptive statistics on risk factor distributions, intervention attendance and length (i.e., with  or = 4 sessions) without disruption of clinic scheduling. Specific risk factor content was delivered as prescribed in 80% or more of the sessions; 78% of sessions were fully completed (where all required risk content was covered). Ninety-three percent of the subsample of intervention women had a positive view of their relationship with their counselor. Most intervention women found the session content helpful. Implementation challenges of addressing multiple risk behaviors are discussed. CONCLUSION: While implementation adjustments and flexibility are necessary, multiple risk behavioral interventions can be implemented in a prenatal care setting without significant disruption of services, and with a majority of referred African American women participating in and expressing satisfaction with treatment sessions.
BT - BMC pregnancy and childbirth
C5 - Healthcare Disparities
CY - England
DO - 10.1186/1471-2393-8-22
JF - BMC pregnancy and childbirth
N2 - BACKGROUND: African American women are at increased risk for poor pregnancy outcomes compared to other racial-ethnic groups. Single or multiple psychosocial and behavioral factors may contribute to this risk. Most interventions focus on singular risks. This paper describes the design, implementation, challenges faced, and acceptability of a behavioral counseling intervention for low income, pregnant African American women which integrated multiple targeted risks into a multi-component format. METHODS: Six academic institutions in Washington, DC collaborated in the development of a community-wide, primary care research study, DC-HOPE, to improve pregnancy outcomes. Cigarette smoking, environmental tobacco smoke exposure, depression and intimate partner violence were the four risks targeted because of their adverse impact on pregnancy. Evidence-based models for addressing each risk were adapted and integrated into a multiple risk behavior intervention format. Pregnant women attending six urban prenatal clinics were screened for eligibility and risks and randomized to intervention or usual care. The 10-session intervention was delivered in conjunction with prenatal and postpartum care visits. Descriptive statistics on risk factor distributions, intervention attendance and length (i.e., with  or = 4 sessions) without disruption of clinic scheduling. Specific risk factor content was delivered as prescribed in 80% or more of the sessions; 78% of sessions were fully completed (where all required risk content was covered). Ninety-three percent of the subsample of intervention women had a positive view of their relationship with their counselor. Most intervention women found the session content helpful. Implementation challenges of addressing multiple risk behaviors are discussed. CONCLUSION: While implementation adjustments and flexibility are necessary, multiple risk behavioral interventions can be implemented in a prenatal care setting without significant disruption of services, and with a majority of referred African American women participating in and expressing satisfaction with treatment sessions.
PP - England
PY - 2008
SN - 1471-2393; 1471-2393
SP - 22
T1 - The design, implementation and acceptability of an integrated intervention to address multiple behavioral and psychosocial risk factors among pregnant African American women
T2 - BMC pregnancy and childbirth
TI - The design, implementation and acceptability of an integrated intervention to address multiple behavioral and psychosocial risk factors among pregnant African American women
U1 - Healthcare Disparities
U2 - 18578875
U3 - 10.1186/1471-2393-8-22
VL - 8
VO - 1471-2393; 1471-2393
Y1 - 2008
ER -